Massachusetts Ride for the Ribbon® to benefit Susan G. Komen for the Cure, Massachusetts Affiliate

REGISTRATION

To participate in the Ride, you must:

1. Register by completing the online form below.

2. Print, sign and mail our Release Form (2012 Release Form - PDF) by the closing date of May 27, 2012. Mail completed forms to Massachusetts Ride for the Ribbon Registrar, 213 Boston Post Road, Wayland, MA 01778.

3. Agree to contribute or raise a minimum donation of $250 by the closing of May 27, 2012. You can make a personal contribution, or ask your friends, neighbors, family, or employers to contribute to Susan G. Komen for the Cure, Massachusetts Affiliate in support of your ride. (Go to our Donations section to learn how to set up your own web page to collect donations and visit our Fundraising Tips section for ideas on how to ask for and collect donations!)

Important Note:

Once you have filled out the entire form, click the SEND button at the bottom of the page. By clicking SEND, you agree to raise the minimum donation amount of $250 by May 27th, 2012; otherwise your spot will be given to another rider.

* - required field

* FIRST AND LAST NAME

* ADDRESS

* CITY

* STATE

* ZIP CODE

* EMAIL

* HOME PHONE

WORK or CELL PHONE

* 1. Riders under 18 years of age must be accompanied by an adult. Are you over 18 years old?

ADULT I WILL RIDE WITH

* 2. ASTM-SEI approved riding helmets are required for all riders. By clicking here, you agree to wear a helmet during the ride. YES, I agree

* 3. T-Shirt size

* 4. Please choose a lunch option

* 5. What is your preferred riding style?

BRIDLE RIBBON

* 6. Are you a survivor?

7. Are you riding in memory of someone or in support of a survivor? If so, please provide their name for your bridle ribbon. You may have up to 4 names on your ribbon

* 8. I will be creating a personal web page to solicit donations and track my fundraising.

If you answered “No” to question 8, please mail in your required minimum donation amount of $250 by May 27th, 2012 using the DONATION FORM available below.

* 9. How did you hear about us?

COMMENTS

Please click SEND once. If you are not brought to a confirmation page, please contact us.

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